Acute pain (tissue discomfort) versus Chronic pain (long lasting irritation)

What is pain?

Pain or discomfort derives from a physical injury, an emotional trauma, or distressing memories.

The chief function of pain is to direct your energies and attention to these states of irritation by inducing deep-seated anxiety to ensure that you know that your body is under threat. Very much like when you touch a burning stove. The shock and fear induce you to retract the hand in micro-seconds knowing that this danger could cause traumatic damage.

What does the nervous system do?

We now know through detailed brain imagery that acute pain (initial pain) travels up the spinal cord via the central nervous system from the site of the tissue damage and into the insula and anterior cingulate cortex which are activated when the tissue nociceptors or pain receptors are stimulated by pressure, swelling, or heat. Your brain and spinal cord constantly receive signals from your muscle spindles and the periphery of the skin to sense the world around us. This system controls your flexibility (or inflexibility) strength, control, and balance.

The spinal cord is like a messenger sending and receiving messages and making decisions in the form of reflexes letting the brain know how badly injured the tissues are. The brain gives the decision as to what to do and how to repair it. Every sensation however feathery light or intensely sharp is experienced through your emotional brain called the limbic brain or our third brain.

 

How does acute pain become Chronic pain?

If you have pain that heals and repairs quickly, we refer to this as acute pain. If the pain lingers especially for longer than 3 months, we call this chronic pain. New research suggests that the brain became used to the irritation and the nervous system is wired to overprotect and guard movements and the fear factor persists. Chronic pain according to brain scans tends to travel from the brain through the spinal cord down into the body even when there is no obvious tissue damage. The scans show that the emotional brain (limbic brain) lights up to a far greater extent and is far more involved with the experience of chronic pain.

It is suggested that we should be rethinking and reframing our techniques to treat chronic pain. A more integrative, holistic approach that includes physical therapy, meditation, and hypnotherapy and helping the client remove the anxiety and fear by adding acceptance and gratitude, and commitment which is part of cognitive therapeutic modalities. The most successful of which is called; “pain re-processing therapy”.

In a new book by Dr. Haider Warraich called “The Song of our scars; the untold story of pain”, he amusingly but succinctly describes present-day pain management by primary healthcare practitioners like chefs who don’t taste their own food. They dish out pain medication like opioids and ibuprofen without really understanding the real causes and effects and feelings of their patients. Treating chronic pain in the same way as you treat acute pain is a big mistake and has led to the opioid crisis around the world. Suffering begets more suffering.

Pain is worsened by psychological factors such as a lack of self-worth and depression. Dr. Warraich had chronic back pain himself and was afraid to do any exercise as he was told he would break his spine. In the end, it made his body weaker and his pain perception more tangible. He clearly states that the nervous system looks at chronic pain as an emotion we feel in our bodies.

 

The brain and pain

Every single body is different and there is no one size that fits all. We as physical therapy practitioners have a huge responsibility to hone our skills carefully in order to try to understand the triggers that our clients are experiencing from a longstanding memory of being hurt or traumatized as a child. With each experience that feels emotionally or physically unsafe, the brain learns to go into a protective mode more quickly and its warning system may become increasingly more sensitive. Health scares during childhood can have a big impact on how protective the nervous system becomes. Injuries or incorrect diagnoses can lead to a more intense experience of pain due to increased amygdala activity. Even the death of a loved one Changes in financial standing or a traumatic event can create this onset of “pain catastrophizing.”

A friend of mine had a high-pressure water hose thrust into his ear. He took Asprin to relieve the pain. Months later he would take Asprin and within seconds of taking it the pain would disappear. He then knew that his pain was psychological, and the pain memory was “Catastophising” the nervous system. Once he realized that and stopped the aspirin the pain went away in days, and never returned.

We know that our nervous system will go into overdrive when these triggers are not managed and therein lies the issue with over-stimulation that we refer to as being chronic pain. Since one in five people are affected by Chronic pain this affects 1.5 billion people around the world. This is a major new step in the treatments and understanding of pain management.

 

Chris Watts- Master mobility trainer

CEO Motion Dynamics

info@motiondynamics.hk

+852 28823397

Sit Less Move More – By Chris Watts

FLEXIBILITY TRAINING

If you believe in the mind/muscle connection, then the more soft-tissue flexibility you possess the more easily and effortlessly it is to move and the more relaxed you will become as a result of unwinding the tense and entangled resistance that occurs in muscles and fascia. Restrictive movements in the soft tissue can often be from overuse and old injuries that never healed well.

Agility is the ability to move freely with less friction within the muscle fibers. Flexibility training often transcends the physical so that you adapt more easily to cope with life’s variable issues. Withstanding stress without excessive effort is the objective.

Body flexibility creates a more positive psychological and more open and expansive mindset.

Anyone can learn to improve their ability to move better.
Movement improvement is the ultimate challenge as we get older, the purpose of which is to attain a better life purpose and draw-back time. Posture improvement allows us to optimize our golf swing, tennis serve, or running stride. It just gets easier to perform any activities at higher levels. You will incur less soft tissue stress as a result of being more pliable and mobile.

Your active end of the range for each of the 360 joints will improve and you move with less effort.

Flexibility training is joint-specific so you can be perfectly mobile on one side of the body and totally hypermobile on the other. It’s like putting high octane fuel back into your car, you move faster, stronger, and with greater efficiency.

Once you begin the road to optimal flexibility you will learn that you can age gracefully and stay active much longer optimizing the way you look, feel and move.

Flexibility training is as much about how you think and perceive life and how you deal with the daily challenges. Flexibility also allows you to go out and try new sports and activities and learn new skills, it gets you out of your comfort zone and ultimately sets you up for a more extraordinary life. As the American slogan goes:” This is the first day of the rest of your life.” So, let’s start to make it better right now.

Flexibility training done well is actually easy and it requires a skill set to get you on the right track. The 2-second Active Isolated Stretching system of dynamic movements focusing on the contracting muscle on one side of the limb to release and relax the target muscles on the opposite side is the safest and most sure-fired approach to achieving quick and long-lasting results. In fitness training the first thing you start to lose is cardio-vascular efficiency, the second is strength and the last is flexibility.
Once this is attained the body will accept the new norm and adapt.

In lifestyle fitness, the first real goal is to boost energy levels. Energy output is my personal goal in all the fitness programs I do. As you get older you really want to focus on more metabolic improvements like some HIIT and some specific cardiovascular workouts with as much variety as you can possibly work with.
Speed variation is one of my big training philosophies, in general as we approach older age we tend to slow down. I am the opposite as I want people to train their neuromuscular and fascial systems to move quicker and with more agility too. Physicality is all about purpose to want to do more and go further and have lots of fun doing it too.

To do this you need to create a more efficient neuromuscular pathway or as we say in our lingo “feed” into the soft tissue removing adhesions and restrictions and allowing the oxygen-rich, alkaline fluids to travel the path of the least resistance. Performance training for your favorite sport is all about creating a more physically efficient you.

Upregulating Oxygen more efficiently and more directly into the 30 trillion cells where energy levels are determined and ultimately converted into action potential is the key thinking when performing at a higher level.

SEDENTARY LIFESTYLES

Sitting here right now writing this article I am acutely aware that I must not sit for any longer than 40 to 45 minutes as I am drying out my intervertebral, cartilaginous disks that act as a cushion for my joints. I am also compressing them as I sit. When we sit, we place 6-8 times more force on our lower lumbar disks than when we stand.

The disk is the only part of our anatomy that has no independent blood supply. It is filled with water and hyaluronic acid as well as a thick collagen matrix. Protecting one’s disks is one of the most important aspects of physical awareness that we can share with our clients as it will prevent so much hardship in the latter years when the disks begin to start their natural degeneration process. Protect your disks as a priority. This is why we spend so much time correcting poor postural patterns as the disks do not like tilts torques and rotations throughout the pelvic girdle. It grinds down the disks and weakens them to eventually lose their integrity and start to bulge and herniate.

Research also tells us that sedentary workers have a 112% increase in onset of Diabetes, Heart and cardiovascular diseases rise by 147% and back pain goes up by over 200%.
This so-called “Sitting disease” is one of the greatest problems of our modern age. Low energy output, little or no physical expenditure, low metabolic activity, less muscle mass, and poor vascularization.

The Goal: Sit less move more.

  • Motion Dynamics invites you to discover the “Friction Free” movement.
  • Book a complimentary 30-minute “Stretch and Align” session by appointment only.
  • Call 28823397 to make an appointment or email us at: info@motiondynamics.hk

Conservative Management of meniscus knee pain with an Olympic athlete using Motion Dynamics protocols

Recipient: Russell Aylsworth, 20 years old. Born in Hong Kong. World sailing ranking 62. Member of the Hong Kong Olympic Sailing team.

Medical report: Russell has several small radial tears in his right knee in the lateral meniscus. (refer radiologist’s report) His Sports Physiotherapist  at the Hong Kong Sports Institute has suggested no surgery. His sports GP has also suggested no surgery. He will be seeing his orthopaedic doctor on Monday 18th May 2021 for a consultation . Should he say no surgery then we at Motion Dynamics will go ahead with a full knee rehabilitation program, 6 to 10 weeks of focused rehabilitation.

What is the Meniscus?

The meniscus are two C-shaped pieces of rubbery cartilage in the knee that fit between the femur (thigh bone) and tibia (shine bone). The meniscus act as shock absorbers and bumpers inside the knee joint. They allow the knee joint to glide smoothly and distribute the forces within the knee during activities such as walking, running, and jumping.

Meniscus Tear Causes and Symptoms

Meniscus tears come in many different shapes and sizes, and they can occur for a variety of reasons. Often times they occur as a result of a specific trauma such as landing awkwardly from a jump or being tackled in football. Other tears occur over time as a result of degeneration (wearing out) of the cartilage. In general, there are five common types of tears –flap, radial, vertical, bucket-handle, and degenerative. Each type has its own set of causes and treatment options.

In cases of traumatic tears, the patient often experiences an acute popping sensation in the knee followed by pain and swelling. In cases of degenerative tears, patients will sometimes experience the slow onset of symptoms. When a meniscus tear is symptomatic, a patient may experience pain, swelling, and/or mechanical symptoms (clicking, catching, and/or locking of the knee).

It is important to understand that each patient is different and the symptoms listed above do not always mean you have a meniscus tear. A diagnosis should be made by an orthopedic surgeon to ensure the injury is treated appropriately.

Diagnosis and Examination

Diagnosis is based on the patient history, physical exam, and imaging (such as X-rays and/or MRI). A meniscus tear can often be diagnosed on physical exam. The McMurray test is used to detect a tear of the meniscus, and will often cause pain and clicking when performed. Additional exam findings include swelling, pain with range of motion, and joint line tenderness. In most cases, x-rays of the knee will appear normal. If there is a concern about a meniscus tear or other knee injury, an MRI is usually performed. An MRI can be used to determine the size and shape of a tear as well as, look for other knee injuries such as cartilage or ligament tears.

Types of Meniscus Tears

The meniscus is a C-shaped structure that sits inside the knee joint. There are different types of meniscus tears and the type of tear can usually be determined with a knee MRI. Described here are 5 common types of meniscus tears.

  • Radial Tear: Radial tears of the meniscus are the most common. These appear as small tears in the inner part of the meniscus. These tears occur in the avascular part of the meniscus (where there is no blood supply) and, as a result, have little ability to heal on their own..

Non-Surgical Treatment for Meniscus Tears

Surgery is not required in all patients with a meniscus tear. Your surgeon will take into consideration the tear type, as well as your specific lifestyle needs when determine the best treatment option. Non-operative treatment often includes a period of rest followed by a course of physical therapy. This allows the patient to build strength in the muscles surrounding the knee joint, allowing for normal knee function with activities. Nonsteroidal anti-inflammatory drugs (NSAIDs) may also be helpful in reducing pain and swelling. Lastly, some patients benefit from a corticosteroid injection into the knee. Corticosteroid is a strong anti-inflammatory and can often relive knee symptoms associated with a torn meniscus.

 

14th May 2021: Postural assessment with Chris Watts CEO Motion Dynamics Limited

Weight bearing assessment:

  • Right hip up-slipped by 1.5 inches.
  • Left side shoulder and hip torque (Twist) left to right by ¾ of an inch. Right shoulder elevated by 1 inch.
  • Both shoulders internally rotated and protracted with left being more prominent in protraction.
  • Right knee is externally rotated and laterally positioned. Tibial torsion on Right lower leg. Biceps femoris very restricted on the right side.
  • 3 Inches of forward head protraction..
  • Mild kyphosis in mid thoracic.
  • Both SI joints are frozen mean no rotation or out-flaring and squish test is negative for mobility.
  • Peroneal muscles on both ankles are weak.

Non-weight bearing postural assessment:

  • Left hip upslip not right as when Russell was standing. Poor S I Joint mobility and no gliding of the joints on both sides.
  • Right leg appears to be ½ inch shorter.
  • Testing the psoas muscle on right side showed that it was severely hypertonic with pain up to 8 out of 10 when palpating. Left Psoas pain level 2 out of 10.
  • Right quadricep is hypertonic and the right pelvis is anteriorly tilted by 10 degrees. Specifically the rectus femoris origin on the AIIS is also hypertonic with a 5 out of 10 pain scale on the trigger point of that origin.
  • Hip external rotation whilst non-weightbearing is very noticeable compared to the left side. Piriformis on right side had less that 10 degrees of rotational motion out of a potential of 45 degrees.
  • Both ankles are very inverted when non weight bearing. Weak evertors.

 

First Treatment: May 14th 2021

Objective report by Chris Watts-Motion Dynamics

Using Positional release therapy a technique designed to reduce tone in the muscles and joints on the Psoas and Iliacus as well as the upper quadriceps on the right side. Used a manual release technique to mobilise the Sacro-Illiac joints on both Illia. Did some sacral  rocking and muscle energy work on the gliding action of the SI Joints.

We assessed Range of Motion on the hip joints. Both hip flexion and hip extension were limited. Right side single leg pelvic tilt was only 140 degrees out of a 160 degree potential and left was 150. Hip extension was zero degrees on both hips. Both psoas major and minor were hypertonic. To improve, Chris used the Active Isolated Stretching techniques with 3 sets on each side to loosen both hips.

Worked on distal hamstrings especially right side and insertions of the biceps femoris into the fibula. We had less than 45 degrees of full knee extension before experiencing sharp irritation to those insertion points on the fibula. Did 3 sets of active assisted stretching to open up the fascial sheaths that were over-shortened and thickened.

His hip/lumbo pelvic imbalances can and do create knee torsion and pressure on the meniscae. Russell was keen to see the link between the structural mechanics and functional bio-mechanics that causes excessive pressure on the tendons and joints.

Objective findings post treatment:

Russell has a straight shoulder, neck and hip alignment. His head is still 2 inches protracted, but his gait is softer and gliding with more fluidity. He was very happy with the session and we look forward to continuing with his spinal mobility and alignment next Thursday.

 

Session 1: May 14th 2021

Subjective findings from Russell Aylsworth

As an elite sailing athlete, strength and conditioning is a vital part of success. An often overlooked area in our training is recovery and mobility. Being in the gym five times a week is very stressful and demanding on the body.

In training, I tore my lateral meniscus in my right knee and decided to see Chris Watts at Motion Dynamics to help my recovery and fix my many other aches and pains through alignment training and postural and mechanical correction exercises.

When first seeing Chris, he did his examination on me with his laser eye vision seeing the errors in my posture, which surprised me to see how very accurate he was in spite of using an eyeball approach and no digital instruments and measurements. He did a very specific Range of Motion testing and joint restriction testing on the sacro-Illiac joints. We found out that I had a very tight hips, in extension and flexion and limited internal rotation on both hips.

To be honest, I didn’t think that my hips bothered me. But after doing his AIS stretching techniques and some manual soft tissue manipulations, I was surprised by how smooth and effortless it was to just walk around the room; I never knew I had this much potential to feel so loose and move so freely with my hips. After this first very enlightening session, I noticed a huge mobility gain for my sport enabling me to be even more fluid in my agility.

The day after the session with Chris, I was surprised how sore I was even though I was lying down for most of the session. The re-alignment of the fascial collagen fibres meant that I experienced some postural shifting and the utilisation of certain muscles that had become deficient from underuse.

I’m excited about next week’s session with Chris to see more improvements in my mobility and fluidity.

 

Session 2: May 20th 2021

Objective assessment from Chris Watts

Postural Re-assessment:

  • Right shoulder protracted.
  • Pec minor hypertonic and winging of right scapula.
  • Serratus anterior right side weak and rhomboids under developed.
  • Left hip upslip only 1/8 inch but causing mild functional lateral spinal flexion with head tilted mildly to right side.
  • Anterior pelvic tilt more noticeable on right iIlium by 10 degrees.
  • Both tibia’s are torqued outwards. Both Biceps femoris hamstrings are tight.

Treatment Plan and techniques

Strengthen the semi-tendinosis and inner thighs.

We spent the first part of the session on aligning the shoulders and removing the tension in the pec minor muscles.

Then used a special technique to stabilise the Rhomboid minor and major with 2 different angles of motion. Worked on stabilising the latissimus dorsi bi-laterally. This really helped with the shoulder and neck alignment.

Spent time on stretching the insertions of the bicep femoris on the lateral epicondyle of the fibula. Very restricted. Hips are more open today than last week. Finished with some upper back extensor stability work. Overall better awareness this week and better control of his mechanics.

 

Session 2: May 20th 2021

Subjective assessment from Russell Aylsworth

Milestones are always great to see. I love the process that I have with Chris because the first thing we do is examine my posture, and it was pleasing to know that I was generally more posturally aligned than last week. Chris determined that I have relatively underdeveloped rhomboids. Rhomboids are the back muscles that help keep the shoulder blades retracted as I have shoulders that roll forwards. I’ve been having upper back pain for a few months and have seen other physiotherapists, and they have never really gotten rid of the knot in my back that’s been nagging at me. I didn’t explain to Chris that I wanted to focus on this because I have gotten to the stage of just not caring about my nagging upper back pain. We started the session by aligning my shoulders and trying to release my very tight pectoral muscles. After releasing my pectoral muscles, the pain in my upper back just disappeared. It amazes me the potential my body has to be so loose and pain-free that Chris can see, and I would never realize without Chris’s help. Something I’ve never enjoyed doing is stretching because of the tingling pain and just makes time unbearably long.

Nevertheless, stretching is still essential for injury prevention and pain-free movement. Chris then worked on my hamstrings, which I have been told by a few physiotherapists and my gym coach that my hamstrings are very tight, but I can’t wait to see the improvement that we will have on them. Something interesting that Chris taught me was reworking my squat mechanics. We used a yoga ball on a wall to practice how my balance and posture are supposed to be while squatting, it felt entirely new for me and something I look forward to progressing. Overall I had an awesome session with Chris. The days after the session with Chris always feels like I’ve just gone to the gym, and it catches me off guard.

 

Session 3: May 28th 2021 

Objective assessment by Chris Watts

Russell had a postural assessment that showed huge improvements to his head and neck alignment as well as hip alignment. No visible torque in the hips. Only right shoulder had a 1 inch right to left torque with shoulder internal rotation and protraction with some winging of the shoulder blade. Tibial torsion on both lower legs has somewhat improved especially on the left leg. The apex of the knee cap is finally straight. The Apex of the right knee is still turned out. Our objective is to work on the tibial rotators such as the biceps femoris and the popliteal muscles to balance out the pressure on the right knee. The ASIS the apex of the knee and the 2nd toe should all be in a straight alignment when standing and walking. There is some improvement on hip flexor mobility too. Right side still tighter than left.

Started to stabilise the upper back especially the rhomboids minor and major for better retraction of the shoulder blade.

 

Session 3, May 28th 2021 

Subjective report by Russell Aylsworth

Chris and I had an excellent start to our session to support my overall growth to better alignment and healing. I had significant improvements in my head and upper body alignment.  My hips still felt loose when I would walk, which was a satisfying feeling. My right shoulder was still slightly protracted forward, which I attribute to a challenging upper body gym session beforehand. We first worked on my shoulder mobility and just loosening up my shoulders. Chris mentioned that I still need to strengthen specific back muscles that have been hindering my posture. I was surprised that even though I think I’m training quite intensively, I’m still neglecting specific vital muscles for posture and feeling pain-free. It’s good to have someone like Chris aware of the muscle development expectations for your body personally.

Since the first session with Chris, my feet and my kneecaps are pointed outwards instead of straight on, which is how it should be. Helping fix my leg posture could potentially take the load off my right knee, which would help my meniscus tear recovery process. Chris went about this by stretching my very tight outer hamstrings and the other two parts of my hamstrings intensively. I think stretching is mentally more challenging to endure than actually lifting weights, so I always have to be relaxed every time Chris works on my legs. We finished off the session by strengthening my upper back muscles, specifically my rhomboids major and minor. Overall it was another solid session with Chris, and always so good to see such a significant improvement every week.

 

Session 4:  May 31st 2021

Objective report by Chris Watts

On the weigh-bearing postural assessment, the pelvis was level in the mid-sagittal plane. However, the pelvis was still tilted forward by 5-10 degrees when measuring the alignment of the ASIS and PSIS. The hip flexors were very hypertonic on both sides especially the right side. For the first time I am able to see that the left and right knees are pointing straight forward. Only the right knee has the tendency to track laterally when walking. We did more pectoralis major and minor stretching which is getting much easier now. Both shoulders have a 60 degree horizontal abduction range, which is target athletic range for that specific movement. Only the internal shoulder rotation is limited . We are at 40 to 50 degrees of rotation and will need to build it to 90 degrees. The infraspinatus on both sides are weak.

Alvin Mesa who has a Master’s Degree in Physiotherapy and works alongside Chris Watts at Motion Dynamics did a series of tests on the right knee ligaments and meniscus. All the results were very functional with no pain or limitation or hypermobility associated with the knee. I believe we can start to do some gentle but focused stability work with the hip/leg and knee internal rotators. We started with the adductor stability program today.

 

Session 4: May 31st 2021

Subjective report from Russell Aylsworth

After my fourth session with Chris, I can say my meniscus tear is almost unnoticeable for my day-to-day life, and if I weren’t diagnosed or have MRI scans, I wouldn’t know I have an injury. A great indicator I have to attest to this is after my 21-day quarantine, I went indoor bouldering, and within 10 minutes, I could feel my right knee seize up, which caused me to stop climbing. Of course, no one likes to feel limited and forced to stop doing things they love. But after four thoughtful sessions with Chris, I was able to indoor boulder for an hour and a half with no issue on my knee. This is very encouraging to me for the potential our bodies have to recover with the guidance of Chris, of course.


This week’s fourth session with Chris was slightly different because I had the opportunity to work with Alvin Cruz, who holds a master’s degree in physiotherapy. The session was split, so I worked with Chris for the first half and Alvin for the second half. Chris started by stretching my pectoral muscles, which showed more flexibility than last week. During the pectoral stretches, I told Chris I had a knot on my upper trap muscle, and Chris knew how to relieve the pressure and work on my upper trapezoid immediately. He eased the tension by simply pushing up my upper trap for only ninety seconds to alleviate the discomfort I was feeling. In addition, Chris identified some muscles apart of my rotator cuffs were underdeveloped, which we will be working on moving forward to minimize the potential for injuries. We then worked on my very tight hip flexors and worked on my stride while walking. It was interesting and funny to learn how to walk again by activating my hip flexors while walking. I then was handed over to Alvin, who assessed my meniscus tear and did a series of tests to ensure that I didn’t have any issues with my ligaments alongside my tear. It gave me confidence when I could do tests like a single-leg pistol squat with relative ease. Alvin then began working on my fascial trigger points on my body and releasing built-up tension I would have got from a heavy gym load. Finally, Alvin spoke to me about how we should start doing knee stability work to regain some of the muscle around my knee joint to support it and hopefully aid recovery. I am very grateful to work with Chris and Alvin to help my body be at its best.

 

5th session: June 9th 2021 

Objective report by Chris Watts

Alignment is significantly improved with all the mid-sagittal plane landmarks balanced. The only area that is still mildly imbalanced is the right shoulder girdle with a 1 inch shoulder protraction. Coronal plane shows a ½ inch forward head and a mild kyphotic T6-T9 curve. Also the right ilium is 10 degrees anteriorly tilted whilst the left ilium is 5 degrees anteriorly tilted.

We began the session with deep psoas and illiacus stretching using the AIS active dynamic stretch techniques which engages the Gluteus maximus medial fibres to extend the hip. We are now able to reach 10-15 degrees of hyperextension on both sides of the hip. This is very different to our first session where we were only able to reach zero degrees of hip extension.

We spent more time on centralising the right patella which is still mildly turned out. We performed 3 sets of outer hamstring (biceps femoris) stretches on both sides. We were able to reach 100 degrees of single leg lifts. This represents full functional ROM for the hamstrings with a locked out knee. Russell also had some DOMS from training the distal hamstrings at the Sports institute that made the stretching more challenging. We landed up doing 3 sets of 12 repetitions on both sides.

We spent 10 minutes releasing the right pectoralis major and minor using Neuromuscular and myofascial release techniques and finished the session with more stability training of the upper back and the shoulder external rotators using the “shoulder-cizer” device.

We have one more training session next week. So far the right meniscus and right knee pain is minimal and barely noticeable, not causing any significant slowing down of his general fitness training.

 

Session 5: June 9th 2021

Subjective report by Russell Aylsworth

Today was the first session with Chris, where my posture was almost entirely aligned except for my right shoulder, which rides forward a little. From an athlete’s perspective, working with Chris has made my body considerably loose. I anecdotally feel that I’ve been able to lift heavier weights in the gym and recover better. Chris and I started our session by working on leg extensions. Even though I did not realize it, Chris saw an improvement in the range I could get; it was motivating to see how much my body can adapt and become healthier with Chris’s help. My hamstrings have always been tight, and when I would see the sports massage people at Sports Institute, and they would always struggle to loosen my hamstrings. Chris is a very determined character and pushes my body to the potential he’s very aware of, and Chris and I work with my awfully tight hamstrings to lengthen them. It was extra tricky this session, especially to work on my hamstrings because I’ve had a gym session just before seeing Chris, yet Chris doesn’t lose confidence in what he does, and we push through together. By the end of the session, we worked on loosening my pectoral muscles from the strenuous effort I put through them from doing some bench presses earlier in that day. After every session with Chris, I always feel light under my feet and just more lively. Doctors have told me that with the type of meniscus tear I have, there is no blood flow going to the Injury, so my meniscus tear will never heal on its own. When I first told Chris about my meniscus tear before I started working with him. He had complete faith and confidence he could help me. It’s fantastic to know someone like Chris who’s invested in who you are and wants the best for you. Since working with Chris, I’ve been pain-free in my right knee and been able to go back and do the sports I love to do and improve and become a better, stronger athlete.

 

6thand final session: June 17th 2021

Objective report by Chris Watts

Assess, Address and Reassess is how we always go through our sessions here at Motion Dynamics.

The postural assessment on Russell showed a ¼ inch elevation to the left shoulder, a ¼ inch

depression of the right occiput and zygomatic arch. The right Illium was anteriorly tilted by 5 degrees only but caused some discomfort in the hips. Russell was unable to note exactly where that discomfort was but he did complain of some upper to mid back irritation.

We started the session with a series of deep AIS stretches of the right Psoas and illiacus. I then showed him how to release those muscles with a self-stretch technique. I noticed that after working on the psoas his right knee which has the radial tears in the meniscus had totally centred so that the apex of the knee cap was pointing directly forward even when he was walking. We did some Rhomboid minor and major stability work to draw back the shoulders 5 degrees. Now the distance between the vertebral border of the scapulae and the spinous processes is around 1.5 inches. For the right shoulder external rotators we were side-lying and used 4kgs for s set of 10 reps and then 5kgs for 10 reps followed by 6kgs at 10 reps. We were at maximum capacity for those shoulder external rotators on the right side.

The shoulder seems to be more naturally retracted and pinned back on the right. We took photographs of Russell’s posture at the end of the session and his knees when standing and walking to highlight the new centralised position. We also used a Swiss “Dipulse” EMS device to stimulate the Vastus Medialis Obliquus on the right thigh. It was very red and very pumped after using 50 hertz and intensity of 32 for 27 minutes.

I recommend that he supplements his training at the Sports Institute with an EMS device for the inner thigh muscles.

 

6th session:  June 17th 2021

Subjective report from Russell Aylsworth

Bittersweet to come to an end of my sessions with Chris and his team at Motion Dynamics. For the past six weeks, I have felt a considerable improvement in my overall posture and just the fluidity I have taken for granted. Being 20, I definitely underestimated how free and lose my body could actually be and never really knew thoroughly the potential my body has to adjust to the new postural alignment. Being very rigorous in the gym, I have neglected certain parts of my recovery. As an elite athlete, I would consider myself a healthy individual who is aware and attentive to my body’s needs. Chris has considerably widened my scope and awareness of the potential my body has to be optimal, and anecdotally I have found my strength and form to improve each session I have in the gym, which is huge and rewarding to see. Chris’s timing was quite good because we did not have anything serious to work on for our final session together.

Today was more of maintaining and providing me with exercise and stretches I could do at home before he sends me off. We did work on strengthening some of my weaker back muscles, such as the Rhomboid minor and major. I told Chris about this knee extension test which compares the strength of my quadriceps and hamstrings. The ratio of quadriceps strength to hamstring strength can help indicate future ACL tears. For myself, because I tore my right meniscus, my inner thigh muscles on my right leg were significantly weaker than my left leg, even though I am right-handed. A neat machine Chris wanted to try the Di-Pulse a Swiss EMS device that sends electric shocks specifically to the muscle to stimulate stress like in the gym. What I found was fascinating about the device was the accuracy it had on my specific muscle. Even though I was lying down in a relaxed position, this specific muscle in my leg was still working. Days after using this EMS Device, that specific muscle had the same soreness from a traditional gym workout.

After my final session with Chris, I was planning on going sailing for the first time in 2 months to see how my knee would fair. Even without surgery and just training my knee and the help I got from Chris has given me no trouble whatsoever, and I wouldn’t be able to tell I had an injury, to begin with. Chris’s warmth and genuine care for his clients are rare to see, and the adaptability matched with his understanding of the complexities of the body is honestly quite fantastic to see and further my knowledge. The type of care I received from Chris is exceptional even though I have exclusive access to the Hong Kong Sports Institution. Chris ‘ attention to the detail ensured that my Postural fitness will stay with me for a very long time. Thank you so much, Chris, for the opportunity to work with you, and helping me along my journey as an athlete is a great experience.

Case study written by Chris Watts- founder and CEO of Motion Dynamics

www.motiondynamics.hk

Tel: +852 28823397

Postural Correction The Missing Link to Preventing Chronic Pain By Chris Watts

Does poor posture and structural abnormalities cause pain? There are multiple research studies showing that clients with forward head posture have increased levels of pain and disability especially in the lower back. Chronic back pain affects 20% of the adult population.

Poor posture poses a risk to the body, as it may be the cause of repetitive stress injuries, micro trauma, and increased stress to the joints, muscles, and connective tissues. When looking down at a screen with the neck at a 45 degree angle and with a protracted head posture, the amount of pressure to the cervical spine is heightened, causing an increased load on all the surrounding neck and shoulder muscles by 40-60 pounds. The result is compression and inflammation.

Proper upright postural design is now being termed Postural Fitness. There is a new Postural paradigm suggesting that poor posture is as much to do with the neurology of balance and proprioception as Musculo-skeletal tension. It is a chicken and egg situation. Which comes first? There is no doubt that Postural correction effects the human design and function. When working with postural imbalances, we as alignment specialists are looking for predictable lasting postural changes.

Posture is the framework of human design for when we move or are upright or seated. Our job as alignment trainers is to identify the resistance and restrictions in the soft tissue and gently but specifically remove them. This is how our Stretch and Align system was born.

Humans are self-healing organisms adapting and overcoming stressors in the environment. Posture affects all the systems which help create sensory motor integration. When posture is weakened, output of the brain is weakened. It can have detrimental effects on our physiology creating what we call “flexor dominance” such as forward head posture, rounded shoulders, flexed pelvis and turned out feet. Our sedentary habits all day everyday can and does cause this weakness.

Postural neurology

The primary role of the nervous system is to prevent flexion dominance, keep us upright and command the muscles to move.

A De-evolved posture is representative of a brain deficit, with shuffling gait patterns, short stride lengths etc. Dynamic and fluid movements create neuroplasticity (brain and body adaptations) and an anti-gravity extension posture.

Here at Motion Dynamics our Stretch and Align program has as a strong awareness component. Postural assessments as well as movement and gait assessments and balance testing is part of our evidence-based practice. Chronic pain can be complex in its pain signalling. Pain does not always tell the truth. It can be regarded as a joker as it can shift and be in a state of flux.

We need to look at structural and neurological balance to de-load the joint structures for best treatment strategies.

The best treatment protocols will get the client out of pain, make them acutely aware of why they are experiencing the discomfort, then help them integrate mobility and stability protocols to prevent ongoing pain from occurring.

The best way to prevent chronic pain is to de-compress the joint structures and create left/right/front/back symmetry. It is all about equilibrium. All 16 functional systems can then work and communicate in tandem.

Neural system

The neural system tunes the motor control and neural pathways, integrating descending instructions from our frontal lobe where gross motor movements are housed. These neural commands are voluntary and involuntary signals. Voluntary ones are produced on demand. 80% of these messages are sent to the contralateral side or opposite side and 20% are sent to the ipsilateral side or same side to help stabilise the opposing movement preventing body sway and aiding our upright posture to remain extended and vertical.

Proprioception is how we move our bodies in the small space that we have been allocated and determines balance and sensation. This afferent input from the visual, vestibular and somato-sensory lets us know how we experience our world around us. The sensations we experience can be warmth, pressure or indeed position, movement or vibration.

The motor cortex in the frontal lobe is constantly in sync with our proprioception. Stability and movement are then in balance.

If movement is jerky or inhibited it may be that the visual or vestibular system is at fault.

The visual, vestibular and motor systems create a total sensory motor integration.

The Vestibular/Occular reflexes work together to co-ordinate movement with vision via the cervical proprioceptors keeping proper head posture. It keeps the spine vertical and the head and eyes in horizontal alignment. The neck is then used as a stability structure for maintaining head alignment. It therefore stimulates upright tone for extension.

We take our cars for MOT checks every year to check tyre and steering balance. Why not do the same with our bodies too.

Movement optimisation feels effortless, frictionless like removing the handbrake off your car.

Chris Watts- CEO Motion Dynamics Ltd

www.motiondynamics.hk

Tel: 28823397